Some studies have demonstrated that RB1 mutations are associated with resistance to anthracyclines in MBC and acquired resistance to T-Dxd in lung cancer,31,32 while functional loss of RB1 was significantly associated with higher response to neo-adjuvant trastuzumab and chemotherapy treatment in the NeoALTTO trial.33 In our study, we found that RB1 alternation was significantly associated with longer PFS, especially in HER2-positive patients, which is consistent with the finding in the NeoALTTO trial. The gene discussed is ERBB2; the disease is lung carcinoma.